Nokea
What urine test result is considered abnormal?
- A. pH 4.0
- B. WBC 1 or 2 cells/ml
- C. Protein level absent
- D. Specific gravity 1.020
Correct Answer: A
Rationale: A urine pH of 4.0 is below the normal range (4.8-7.8) and may indicate urinary tract infection or metabolic imbalances. WBC of 1-2 cells/ml, absent protein, and specific gravity of 1.020 (within 1.001-1.030) are normal and not indicative of pathology.
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What laboratory finding, in conjunction with the presenting symptoms, indicates minimal change nephrotic syndrome?
- A. Low specific gravity
- B. Decreased hemoglobin
- C. Normal platelet count
- D. Reduced serum albumin
Correct Answer: D
Rationale: Reduced serum albumin, due to significant proteinuria, is a hallmark of minimal change nephrotic syndrome (MCNS). Specific gravity is high due to protein loss, hemoglobin is normal or elevated, and platelet counts are elevated from hemoconcentration, not normal.
The nurse notes that a child has lost 3.6 kg (8 lb) after 4 days of hospitalization for acute glomerulonephritis. What is the most likely cause of this weight loss?
- A. Poor appetite
- B. Reduction of edema
- C. Restriction to bed rest
- D. Increased potassium intake
Correct Answer: B
Rationale: Rapid weight loss of 8 lb in 4 days in acute glomerulonephritis is due to improved renal function and mobilization of edema fluid. Poor appetite and bed rest don?t cause such significant loss, and potassium is restricted, not increased, until renal function normalizes.
A 12-year-old child is injured in a bicycle accident. When considering the possibility of renal trauma, the nurse should consider what factor?
- A. Flank pain rarely occurs in children with renal injuries.
- B. Few nonpenetrating injuries cause renal trauma in children.
- C. Kidneys are immobile, well protected, and rarely injured in children.
- D. The amount of hematuria is not a reliable indicator of the seriousness of renal injury.
Correct Answer: D
Rationale: Hematuria is common in renal trauma but doesn?t correlate with injury severity. Flank pain often occurs due to bleeding, most renal trauma in children is from blunt injuries like accidents, and children?s kidneys are more mobile and less protected, increasing injury risk.
What diagnostic test allows visualization of renal parenchyma and renal pelvis without exposure to external-beam radiation or radioactive isotopes?
- A. Renal ultrasonography
- B. Computed tomography
- C. Intravenous pyelography
- D. Voiding cystourethrography
Correct Answer: A
Rationale: Renal ultrasonography uses ultrasonic waves to visualize renal structures without radiation or isotopes. CT and intravenous pyelography involve external radiation, often with contrast, and voiding cystourethrography uses radiation and contrast injected into the bladder.
What pathologic process is believed to be responsible for the development of postinfectious glomerulonephritis?
- A. Infarction of renal vessels
- B. Immune complex formation and glomerular deposition
- C. Bacterial endotoxin deposition on and destruction of glomeruli
- D. Embolization of glomeruli by bacteria and fibrin from endocardial vegetation
Correct Answer: B
Rationale: Postinfectious glomerulonephritis results from immune complexes formed after streptococcal infection, depositing in glomerular capillaries. Renal vessel infarction occurs in sickle cell disease, bacterial endotoxins aren?t involved, and embolization is linked to bacterial endocarditis.